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Study Evaluating On-Demand Treatment With BeneFIX In Chinese Subjects

An Evaluation Of The Safety And Efficacy Of On-Demand Treatment With BeneFIX (Nonacog Alfa, Recombinant Factor IX) In Chinese Subjects With Hemophilia B

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00866606
Enrollment
35
Registered
2009-03-20
Start date
2009-02-28
Completion date
2009-12-31
Last updated
2011-04-05

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Hemophilia B

Keywords

On-demand treatment, Hemostatic efficacy, Factor IX activity, Factor IX recovery, Factor IX inhibitor, Chinese

Brief summary

This study will evaluate the safety and efficacy of on-demand treatment with BeneFIX in Chinese hemophilia B subjects.

Interventions

BIOLOGICALBenefix

BeneFIX for on-demand treatment of bleeding episodes were according to investigator prescription. FIX recovery was assessed by determining the FIX activity (FIX:C) levels in individual subjects. BeneFIX dosage for recovery assessments: single 75 IU/kg (±5 IU/kg) IV bolus infusion.

Sponsors

Wyeth is now a wholly owned subsidiary of Pfizer
Lead SponsorINDUSTRY

Study design

Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
6 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Subjects equal or more than 6 years of age with mild, moderate or severe hemophilia B (FIX activity: more than 5%, 1-5%, or less than 1%, respectively) * Subjects with previous exposure to FIX replacement therapy * If HIV positive, documented CD4 count more than 200/µL within 6 months of study entry

Exclusion criteria

* Diagnosed with any bleeding disorder in addition to hemophilia B * Current FIX inhibitor or history of FIX inhibitor (defined as \>ULN of the reporting laboratory) * Subject has no history of exposure to FIX products (previously untreated patient \[PUP\]) * Subject is currently utilizing primary FIX prophylaxis * Subjects anticipating elective surgery that may be planned to occur in the 6 months following study entry * Treated with immunomodulatory therapy within 30 days prior to study entry or planned use for the duration of their study participation * Participated in another investigational drug or device study within 30 days prior to study entry or planned participation for the duration of their study participation * Subjects with a known hypersensitivity to hamster protein * Significant hepatic or renal impairment (ALT and AST \>5 x ULN, bilirubin \>2 mg/dL or serum creatinine \>1.25 x ULN) * Prothrombin Time \>1.5 x ULN * Platelet count \<80,000/µL * Pregnant or breastfeeding women * Unwilling or unable to follow the terms of the protocol * Any condition which may compromise the subject's ability to comply with and/or perform study-related activities or that poses a clinical contraindication to study participation, in the opinion of the Investigator or Sponsor

Design outcomes

Primary

MeasureTime frameDescription
Investigator Hemostatic Efficacy Assessment of Participants After 8 Hours Post Infusion8 hours post infusionInvestigator Hemostatic Efficacy Assessment was based on response of bleeding episodes to BeneFIX treatment on 4-point rating scale: Excellent(1): definite pain relief or improvement in signs of bleeding starting within 8 hrs after infusion, with no additional infusion; Good(2): definite pain relief or improvement in signs of bleeding starting within 8 hrs or following infusion; Moderate(3): probable or slight improvement starting after 8 hours following infusion; No Response(4): no improvement at all between infusions or during 24 hour interval following an infusion, or condition worsens.
Investigator Hemostatic Efficacy Assessment of Participants After 24 Hours Post Infusion24 hours post infusionInvestigator Hemostatic Efficacy Assessment was based on response of bleeding episodes to BeneFIX treatment on 4-point rating scale: Excellent(1): definite pain relief or improvement in signs of bleeding starting within 8 hrs after infusion, with no additional infusion; Good(2): definite pain relief or improvement in signs of bleeding starting within 8 hrs or following infusion; Moderate(3): probable or slight improvement starting after 8 hours following infusion; No Response(4): no improvement at all between infusions or during 24 hour interval following an infusion, or condition worsens.
Percentage of Participants With FIX Inhibitor DevelopmentBaseline up to 6 monthsIncidence of FIX inhibitor was defined as any result determined as positive at local laboratory, and confirmed at central laboratory with Nijmegen assay result \>=0.6 Bethesda Unit (BU). Incidence was stratified by participant exposure history - Minimally Treated Patients (MTPs): those who had received at least one prior FIX infusion, and \<= 100 documented Exposure Days (EDs); while Previously Treated Patients (PTPs): those who had received \>100 documented prior EDs. When number of prior EDs for an individual was not known to be at least 100, participants were included in the MTP population.

Secondary

MeasureTime frameDescription
Percentage of Participants With Allergic-Type Allergic ReactionsBaseline up to 6 monthsHypersensitivity to undesirable (damaging, discomfort-producing and sometimes fatal) reactions produced by the normal immune system. Hypersensitivity reactions require a pre-sensitized (immune) state of the host.
Number of Infusions Required to Treat Each BleedBaseline up to 6 monthsThe number of BeneFIX infusions required to treat each bleeding episode were analyzed. The average frequency of BeneFIX infusions per hemorrhage incidence to treat every hemorrhage was equal to the total number of injections throughout the study divided by total number of hemorrhagic events.
Percentage of Participants With Red Blood Cell (RBC) AgglutinationBaseline up to 6 monthsRBC Agglutination is the clumping of red blood cells in the presence of an antibody. The antibody or other molecule bonded multiple particles and joined them, creating a large complex.
Percentage of Participants With ThrombosisBaseline up to 6 monthsThrombosis is the formation of a blood clot (thrombus) inside a blood vessel, obstructing the flow of blood through the circulatory system. When a blood vessel is injured, the body uses platelets and fibrin to form a blood clot to prevent blood loss.
FIX Incremental RecoveryBaseline (Visit 2) up to 6 months (Visit 4)FIX recovery was assessed by evaluating FIX:C after initial exposure and following 6 months of repeated exposures to BeneFIX. A modified FIX recovery study was performed at Day 1 (Visit 2) and Month 6/Final/Early Termination visits (Visit 4) and when clinically indicated at the applicable on-demand visits. Blood samples for determination of FIX:C were collected immediately before BeneFIX infusion and at 30 minutes (±5 minutes) after the start of infusion. Post-infusion blood samples were collected via venipuncture in arm contralateral to arm used for infusion.
Percentage of Participants With Less Than Expected Therapeutic Effect (LETE)Baseline up to 6 monthsThe incidence of LETE for on-demand treatment was defined as no response after each of 2 successive infusions within 24 hours for the same bleeding event in the absence of confounding factors.

Countries

China

Participant flow

Recruitment details

Participants were enrolled in six centers in China.

Participants by arm

ArmCount
BeneFactor IX (BeneFIX)
Participants received on-demand treatments with BeneFIX according to investigator's prescription over a 6-month (calendar day) period. A single 75 International Unit (IU)/kg (±5 IU/kg) intravenous (IV) bolus infusion of BeneFIX was given for recovery assessments. All BeneFIX administrations occurred in the clinic (hospital).
35
Total35

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyAdverse Event1
Overall StudyLost to Follow-up3

Baseline characteristics

CharacteristicBeneFactor IX (BeneFIX)
Age Continuous25.7 Years
STANDARD_DEVIATION 13.6
Sex: Female, Male
Female
0 Participants
Sex: Female, Male
Male
35 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
— / —
other
Total, other adverse events
19 / 35
serious
Total, serious adverse events
2 / 35

Outcome results

Primary

Investigator Hemostatic Efficacy Assessment of Participants After 24 Hours Post Infusion

Investigator Hemostatic Efficacy Assessment was based on response of bleeding episodes to BeneFIX treatment on 4-point rating scale: Excellent(1): definite pain relief or improvement in signs of bleeding starting within 8 hrs after infusion, with no additional infusion; Good(2): definite pain relief or improvement in signs of bleeding starting within 8 hrs or following infusion; Moderate(3): probable or slight improvement starting after 8 hours following infusion; No Response(4): no improvement at all between infusions or during 24 hour interval following an infusion, or condition worsens.

Time frame: 24 hours post infusion

Population: FAS population included all participants who were treated and had at least 1 evaluable efficacy assessment after treatment.

ArmMeasureValue (MEAN)Dispersion
BeneFactor IX (BeneFIX)Investigator Hemostatic Efficacy Assessment of Participants After 24 Hours Post Infusion1.58 Units on a scaleStandard Deviation 0.71
Primary

Investigator Hemostatic Efficacy Assessment of Participants After 8 Hours Post Infusion

Investigator Hemostatic Efficacy Assessment was based on response of bleeding episodes to BeneFIX treatment on 4-point rating scale: Excellent(1): definite pain relief or improvement in signs of bleeding starting within 8 hrs after infusion, with no additional infusion; Good(2): definite pain relief or improvement in signs of bleeding starting within 8 hrs or following infusion; Moderate(3): probable or slight improvement starting after 8 hours following infusion; No Response(4): no improvement at all between infusions or during 24 hour interval following an infusion, or condition worsens.

Time frame: 8 hours post infusion

Population: FAS population included all participants who were treated and had at least 1 evaluable efficacy assessment after treatment.

ArmMeasureValue (MEAN)Dispersion
BeneFactor IX (BeneFIX)Investigator Hemostatic Efficacy Assessment of Participants After 8 Hours Post Infusion1.70 Units on a scaleStandard Deviation 0.72
Primary

Percentage of Participants With FIX Inhibitor Development

Incidence of FIX inhibitor was defined as any result determined as positive at local laboratory, and confirmed at central laboratory with Nijmegen assay result \>=0.6 Bethesda Unit (BU). Incidence was stratified by participant exposure history - Minimally Treated Patients (MTPs): those who had received at least one prior FIX infusion, and \<= 100 documented Exposure Days (EDs); while Previously Treated Patients (PTPs): those who had received \>100 documented prior EDs. When number of prior EDs for an individual was not known to be at least 100, participants were included in the MTP population.

Time frame: Baseline up to 6 months

Population: Safety Set (SS) population included all enrolled participants who had taken at least 1 dose of drug.The 'n' is signifying those participants who received study drug and were evaluated for this measure at the timepoint for each visit respectively.

ArmMeasureGroupValue (NUMBER)
BeneFactor IX (BeneFIX)Percentage of Participants With FIX Inhibitor DevelopmentTotal (n=35)2.86 Percentage of Participants
BeneFactor IX (BeneFIX)Percentage of Participants With FIX Inhibitor DevelopmentMTP (n=24)4.17 Percentage of Participants
BeneFactor IX (BeneFIX)Percentage of Participants With FIX Inhibitor DevelopmentPTP (n=11)0 Percentage of Participants
Secondary

FIX Incremental Recovery

FIX recovery was assessed by evaluating FIX:C after initial exposure and following 6 months of repeated exposures to BeneFIX. A modified FIX recovery study was performed at Day 1 (Visit 2) and Month 6/Final/Early Termination visits (Visit 4) and when clinically indicated at the applicable on-demand visits. Blood samples for determination of FIX:C were collected immediately before BeneFIX infusion and at 30 minutes (±5 minutes) after the start of infusion. Post-infusion blood samples were collected via venipuncture in arm contralateral to arm used for infusion.

Time frame: Baseline (Visit 2) up to 6 months (Visit 4)

Population: FAS population included all participants who were treated and had at least 1 evaluable efficacy assessment after treatment. The 'n' is signifying those participants who received study drug and were evaluated for this measure at the timepoint for each visit respectively.

ArmMeasureGroupValue (MEAN)Dispersion
BeneFactor IX (BeneFIX)FIX Incremental RecoveryVisit 2 (n=30)0.760 IU/dL per IU/kgStandard Deviation 0.222
BeneFactor IX (BeneFIX)FIX Incremental RecoveryVisit 4 (n=31)0.727 IU/dL per IU/kgStandard Deviation 0.275
Secondary

Number of Infusions Required to Treat Each Bleed

The number of BeneFIX infusions required to treat each bleeding episode were analyzed. The average frequency of BeneFIX infusions per hemorrhage incidence to treat every hemorrhage was equal to the total number of injections throughout the study divided by total number of hemorrhagic events.

Time frame: Baseline up to 6 months

Population: FAS population included all participants who were treated and had at least 1 evaluable efficacy assessment after treatment.

ArmMeasureValue (MEAN)Dispersion
BeneFactor IX (BeneFIX)Number of Infusions Required to Treat Each Bleed1.20 InfusionsStandard Deviation 0.86
Secondary

Percentage of Participants With Allergic-Type Allergic Reactions

Hypersensitivity to undesirable (damaging, discomfort-producing and sometimes fatal) reactions produced by the normal immune system. Hypersensitivity reactions require a pre-sensitized (immune) state of the host.

Time frame: Baseline up to 6 months

Population: SS population included all enrolled participants who had taken at least 1 dose of drug.

ArmMeasureValue (NUMBER)
BeneFactor IX (BeneFIX)Percentage of Participants With Allergic-Type Allergic Reactions0 Percentage of Participants
Secondary

Percentage of Participants With Less Than Expected Therapeutic Effect (LETE)

The incidence of LETE for on-demand treatment was defined as no response after each of 2 successive infusions within 24 hours for the same bleeding event in the absence of confounding factors.

Time frame: Baseline up to 6 months

Population: FAS population included all participants who were treated and had at least 1 evaluable efficacy assessment after treatment.

ArmMeasureValue (NUMBER)
BeneFactor IX (BeneFIX)Percentage of Participants With Less Than Expected Therapeutic Effect (LETE)0 Percentage of Participants
Secondary

Percentage of Participants With Red Blood Cell (RBC) Agglutination

RBC Agglutination is the clumping of red blood cells in the presence of an antibody. The antibody or other molecule bonded multiple particles and joined them, creating a large complex.

Time frame: Baseline up to 6 months

Population: SS population included all enrolled participants who had taken at least 1 dose of drug.

ArmMeasureValue (NUMBER)
BeneFactor IX (BeneFIX)Percentage of Participants With Red Blood Cell (RBC) Agglutination0 Percentage of Participants
Secondary

Percentage of Participants With Thrombosis

Thrombosis is the formation of a blood clot (thrombus) inside a blood vessel, obstructing the flow of blood through the circulatory system. When a blood vessel is injured, the body uses platelets and fibrin to form a blood clot to prevent blood loss.

Time frame: Baseline up to 6 months

Population: SS population included all enrolled participants who had taken at least 1 dose of drug.

ArmMeasureValue (NUMBER)
BeneFactor IX (BeneFIX)Percentage of Participants With Thrombosis0 Percentage of Participants

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026